Lymphangiosarcoma: Is Stewart-Treves Syndrome a Preventable Condition?

Authors:
Gunther Felmerer
Gunther Felmerer
University of Medicine
Germany
Maria G Ahls
Maria G Ahls
5 Institute of Pathology
Podgorica | Montenegro
Philipp Strobel
Philipp Strobel
University of Ulm
Germany
Thiha Aung
Thiha Aung
Georg-August-University Goettingen
Germany

Lymphat Res Biol 2016 Mar 19;14(1):35-9. Epub 2015 Nov 19.

1 Division of Plastic Surgery, Department of Trauma Surgery, Plastic and Reconstructive Surgery, University Medical Centre , Göttingen, Germany .

Background: Stewart-Treves syndrome is a rare complication of breast cancer treatment, representing a lymphangiosarcoma commonly associated with lymphedema and severely impacting patient's outcome. The tumor typically develops in the atrophic, pachydermatous, hyperkeratotic skin of limbs affected by long-standing lymphedema. Clinical data associated with Stewart-Treves syndrome and lymphedema management have rarely been published.

Methods And Results: In the period between 1980 and 2009, ten patients with Stewart-Treves syndrome were diagnosed and treated at the Foeldiklinik, Hinterzarten, Germany. Nine of the ten patients were female. Five patients had previously suffered from breast cancer (and were treated with mastectomy); two from other malignancies; two patients had primary lymphedema, and one had undergone lower extremity lymphadenectomy. All cancer patients had undergone radiation treatment. In all cases, the sarcoma developed in non-irradiated areas 6-48 years (average 16.3 years) after the onset of lymphedema. None of the patients had received complex decongestive physical therapy (CDT). Two patients had above-elbow amputation, one had shoulder exarticulation, two patients had wide excision and skin grafting, two patients had above-knee amputation procedure, two patients had a below-knee amputation procedure, and one patient had no surgical treatment at all. The time to recurrence after surgery, time to metastasis, patient survival and CDT were recorded.

Conclusions: Patients with lymphedema should be closely examined starting 5 years from the time of lymphedema onset, paying special attention to those with associated malignancies. Only early diagnosis and treatment by radical ablative surgery confers a reasonable prognosis with this rare but aggressive disease. A potential effect of CDT on lymphangiosarcoma has to be studied in a greater patient cohort.

Download full-text PDF

Source
http://dx.doi.org/10.1089/lrb.2015.0006DOI Listing

Still can't find the full text of the article?

Sign up to send a request to the authors directly.
March 2016
30 Reads

Publication Analysis

Top Keywords

stewart-treves syndrome
16
patients
11
breast cancer
8
amputation procedure
8
ten patients
8
lymphedema
7
therapy cdt
4
physical therapy
4
decongestive physical
4
received complex
4
lymphedema patients
4
patients received
4
cdt patients
4
complex decongestive
4
above-elbow amputation
4
skin grafting
4
excision skin
4
grafting patients
4
patients above-knee
4
above-knee amputation
4

Similar Publications

Sustained release ophthalmic dexamethasone: In vitro in vivo correlations derived from the PK-Eye.

Int J Pharm 2017 Apr 21;522(1-2):119-127. Epub 2017 Feb 21.

Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Butler University, Indianapolis, IN 46208, USA. Electronic address:

Corticosteroids have long been used to treat intraocular inflammation by intravitreal injection. We describe dexamethasone loaded poly-DL-lactide-co-glycolide (PLGA) microparticles that were fabricated by thermally induced phase separation (TIPS). The dexamethasone loaded microparticles were evaluated using a two-compartment, in vitro aqueous outflow model of the eye (PK-Eye) that estimates drug clearance time from the back of the eye via aqueous outflow by the anterior route. Read More

View Article
April 2017
20 Reads
1 PubMed Central Citation(source)
3.65 Impact Factor

Hemosiderosis causing liver cirrhosis in a patient with Hb S/beta thalassemia and no other known causes of hepatic disease.

Hippokratia 2017 Jan-Mar;21(1):43-45

1 Department of Internal Medicine, Papageorgiou General Hospital, Thessaloniki, Greece.

Background: Hemosiderosis in the absence of blood transfusions has been encountered in conditions associated with ineffective erythropoiesis but not in sickle-cell disease (SCD). Description of the case: We report a case of a 34-year-old Caucasian male, with a history of SCD and beta thalassemia (Hb S/β-thal) who presented with acute painful crises. Despite never having received regular blood transfusions in the past, the patient demonstrated elevated ferritin levels and transferrin saturation of 83 %. Read More

View Article
June 2018
23 Reads
0.36 Impact Factor

XGR software for enhanced interpretation of genomic summary data, illustrated by application to immunological traits.

Genome Med 2016 12 13;8(1):129. Epub 2016 Dec 13.

Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, OX3 7BN, UK.

Background: Biological interpretation of genomic summary data such as those resulting from genome-wide association studies (GWAS) and expression quantitative trait loci (eQTL) studies is one of the major bottlenecks in medical genomics research, calling for efficient and integrative tools to resolve this problem.

Results: We introduce eXploring Genomic Relations (XGR), an open source tool designed for enhanced interpretation of genomic summary data enabling downstream knowledge discovery. Targeting users of varying computational skills, XGR utilises prior biological knowledge and relationships in a highly integrated but easily accessible way to make user-input genomic summary datasets more interpretable. Read More

View Article
December 2016
15 Reads
4 PubMed Central Citations(source)
4.94 Impact Factor

Deuterated detergents for structural and functional studies of membrane proteins: Properties, chemical synthesis and applications.

Mol Membr Biol 2015 Aug-Dec;32(5-8):139-55. Epub 2016 Feb 24.

e University of Leeds , Leeds , UK.

Detergents are amphiphilic compounds that have crucial roles in the extraction, purification and stabilization of integral membrane proteins and in experimental studies of their structure and function. One technique that is highly dependent on detergents for solubilization of membrane proteins is solution-state NMR spectroscopy, where detergent micelles often serve as the best membrane mimetic for achieving particle sizes that tumble fast enough to produce high-resolution and high-sensitivity spectra, although not necessarily the best mimetic for a biomembrane. For achieving the best quality NMR spectra, detergents with partial or complete deuteration can be used, which eliminate interfering proton signals coming from the detergent itself and also eliminate potential proton relaxation pathways and strong dipole-dipole interactions that contribute line broadening effects. Read More

View Article
January 2018
25 Reads
1.69 Impact Factor

"Late-late" retrograde collateral filling from occluded donor coronary artery.

Int J Cardiol 2006 Sep 12;112(2):e42-4. Epub 2006 Jul 12.

We present a case where the chronically occluded right coronary artery fed retrograde the acutely occluded left anterior descending artery. The "late-late" filling of the target vessel served as a good guide for the recanalisation procedure. Read More

View Article
September 2006
8 Reads
4.04 Impact Factor